PubMed · 14347714
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G KUENTSCHER. 1964-11-17. [PRIMARY BONE HEALING].. https://pubmed.ncbi.nlm.nih.gov/14347714/
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3D bioprinting has begun to show great promise in advancing the development of functional tissue/organ replacements. However, to realize the true potential of 3D bioprinted tissues for clinical use requires the fabrication of an interconnected and effective vascular network. Solving this challenge is critical, as human tissue relies on an adequate network of blood vessels to transport oxygen, nutrients, other chemicals, biological factors and waste, in and out of the tissue. Here, we have successfully designed and printed a series of novel 3D bone scaffolds with both bone formation supporting structures and highly interconnected 3D microvascular mimicking channels, for efficient and enhanced osteogenic bone regeneration as well as vascular cell growth. Using a chemical functionalization process, we have conjugated our samples with nano hydroxyapatite (nHA), for the creation of novel micro and nano featured devices for vascularized bone growth. We evaluated our scaffolds with mechanical testing, hydrodynamic measurements and in vitro human mesenchymal stem cell (hMSC) adhesion (4 h), proliferation (1, 3 and 5 d) and osteogenic differentiation (1, 2 and 3 weeks). These tests confirmed bone-like physical properties and vascular-like flow profiles, as well as demonstrated enhanced hMSC adhesion, proliferation and osteogenic differentiation. Additional in vitro experiments with human umbilical vein endothelial cells also demonstrated improved vascular cell growth, migration and organization on micro-nano featured scaffolds.
Bonelike/PLGA hybrid materials have been developed using gamma-MPS as silane-coupling agent between the inorganic and organic phases for controlled drug delivery applications. Silanization showed to be more effective when cyclohexane was used as a non-polar solvent (nP method) due to a chemical interaction between Bonelike, and the silane film, while by using a 95/5 (V/V) methanol/water as a polar solvent (P method), a much thinner film was achieved. Functional groups of PLGA, such as the carbonyl group (C=O), were identified using Raman and FTIR-ATR analysis and therefore these groups may be used to link therapeutic molecules. These novel hybrid materials prepared by combining silanization and post-hybridisation processes are expected to find use in medical applications of bone regeneration and as drug delivery carrier for therapeutic molecules.
STUDY DESIGN: Prospective assessment of the reliability of determining cervical fusion success based on plain radiographs. OBJECTIVES: Determination of the reliability of plain static radiographs in predicting the presence or absence of fusion. SUMMARY OF BACKGROUND DATA: The ability of plain radiographs to assess the presence of fusion is limited. In addition, variations in the definition of "fusion" make this entity an important aspect for study. METHODS: A study was carried out to determine the reliability of plain radiographs in predicting bony fusion. Cases of cervical spondylosis undergoing a single or multilevel corpectomy with an allograft fusion and anterior instrumentation were chosen for the model. The definition of "bony fusion" was obtained from the literature. Bony fusion was defined by the presence of bony trabeculation across the graft-host interfaces, the assessment of the change in strut height over time, and the development of a kyphotic angulation over time. Data were collected at a tertiary care institution over a 5-year period. Descriptive statistics regarding baseline patient characteristics, the underlying disease process, and the surgical intervention, were obtained. Reliability of plain static radiographs in assessing fusion was evaluated by two independent neuroradiologists blinded to any subsequent clinical outcome. The Cohen Kappa statistic was used to determine the degree of agreement regarding the presence or absence of fusion at the superior and inferior aspect of the graft at the 6-week and the 12-week follow-up. RESULTS: The study involved 57 patients (30 males and 27 females), with a median age of 49 years. The number of levels decompressed was 1, 2, and 3 in 36, 20, and 1 patients, respectively. Fourteen patients had a history of smoking. The Cohen Kappa statistic revealed variable results depending on the time period and aspect evaluated. The degree of agreement at 6 weeks was 0.61 (95% confidence interval = 0.32-0.89) and 0.44 (95% confidence interval = 0.017-0.86) and at 12 weeks was 0.18 (95% confidence interval = -0.21-0.58) and 1.00 for the superior and inferior aspect of the graft, respectively. CONCLUSIONS: Plain radiographs are generally quite unreliable in predicting fusion based on presence or absence of trabeculation.